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Thoracic Involvement of Type A Aortic Dissection and Intramural Hematoma: Diagnostic Accuracy—Comparison of Emergency Helical CT and Surgical Findings
Abstract
PURPOSE: To assess the accuracy of various findings at emergency helical computed tomography (CT) for the evaluation of thoracic involvement of type A aortic dissection (AD) and type A intramural hematoma (IMH) and to compare these findings with those at surgical confirmation. MATERIALS AND METHODS: Fifty-seven patients with acute chest pain underwent emergency helical CT and subsequent surgery for type A AD or IMH. Patients in whom AD or IMH was detected in three segments of the thoracic aorta or those in whom there was a site of any entry tear, arch branch vessel involvement, pericardial effusion, or aortic arch anomaly were examined at helical CT. Sensitivity, specificity, and accuracy of helical CT, along with 95% CIs, were calculated by using surgical confirmation as the reference standard. RESULTS: For the detection of AD or IMH of the thoracic aorta, the accuracy of helical CT was 100%. The sensitivity, specificity, and accuracy, respectively, were 82%, 100%, and 84% for an entry tear; 95%, 100%, and 98% for arch branch vessel involvement; and 83%, 100%, and 91% for pericardial effusion. These values were all 100% for aortic arch anomalies. CONCLUSION: Emergency helical CT of the thorax depicts findings that are highly accurate in the evaluation of acute type A AD and IMH.
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WRITING GROUP MEMBERS, Hiratzka, L. F., Bakris, G. L., Beckman, J. A., Bersin, R. M., Carr, V. F., Casey, D. E., Eagle, K. A., Hermann, L. K., Isselbacher, E. M., et al. (2010) · Circulation · doi:10.1161/cir.0b013e3181d4739e · Cited by 2,289
Isselbacher, E. M., Preventza, O., Hamilton Black, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001106 · Cited by 2,082
Goldstein, S. A., Evangelista, A., Abbara, S., Arai, A., Asch, F. M., Badano, L. P., Bolen, M. A., Connolly, H. M., Cuéllar-Calàbria, H., Czerny, M., et al. (2015) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2014.11.015 · Cited by 641
EACTS/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ
Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., et al. (2024) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezad426 · Cited by 412
EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ
Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., et al. (2024) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2024.01.021 · Cited by 331
Metadata
- Authors
- Yoshida, S., Akiba, H., Tamakawa, M., Yama, N., Hareyama, M., Morishita, K., & Abe, T.
- Venue
- Radiology
- Published
- 2003-08
- Volume
- 228
- Issue
- 2
- Pages
- 430-435
- ISSN
- 0033-8419 (ISSN-L)
- 1527-1315
- OpenAlex
- W2062570821
- Cited by
- 170
- References
- 0
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- closed
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- Yoshida, S., Akiba, H., Tamakawa, M., Yama, N., Hareyama, M., Morishita, K., & Abe, T. (2003). Thoracic Involvement of Type A Aortic Dissection and Intramural Hematoma: Diagnostic Accuracy—Comparison of Emergency Helical CT and Surgical Findings. Radiology. https://doi.org/10.1148/radiol.2282012162
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